Over the last week Reuters, ABC news, MSNBC,BBC News, and more than 75 other outlets reported on how two "two new studiesadd to growing evidence that morphine and other opiate-based painkillers maypromote the growth and spread of cancer cells."

The headlines all blared hyperbolic and falseoversimplifications of the impact of the research. Now I am no opioid apologist,but I do have to recognize that I spend a great deal of my education topatients, families, staff, and other doctors de-stigmatizing opioids so they maybe used effectively for good pain control while balancing their manageablerisks. So while I nearly always am defending appropriate opioid prescribing, Ialso want to recognize if there is potential harm in its use.

All these articles (most stemming from aninitial Reuters report) discussed the recent presentation by a group from the University of Chicago on the mu-opioid antagonistmethylnaltrexone (otherwise known as Relistor or “that new opioid inducedconstipation medication”). This work, as presented at a meeting in Boston, revealed that usemethylnaltrexone prevented tumor-cell proliferation and migration in culturedlung cancer cells.

The most important take home point is that noneof these studies actually looked at opioid use (although many of the newsarticles vaguely cite these studies as evidence for morphine’s deleteriouseffects on cancer). Even if you want to argue that these were high qualitystudies and there is a clear benefit of regional anesthesia, opioids should notbe singled out as the cause.

Their take home message = “There is no clinical evidence that morphine, or any other opioids, cause real harm through stimulating cancer growth.” The evidence will definitely have to be more substantial before we sound the alarms for the general public!

Journal of Clinical Oncology Current Issue

The Lancet Oncology

European Journal of Cancer - Articles in Press

Journal of Oncology Pharmacy Practice current issue

About Onco-PRN

Welcome and thanks for visiting Onco-P.R.N. - The oncology website with a focus on all things oncology pharmacy/pain/palliative care-related. It is intended to be an information resource for those pharmacist and relevant health care professionals involved in whatever fashion with cancer and palliative care. Stay tuned for the latest and greatest links and information with respect to: oncology medications, continuing education, pharmaceutical care initiatives, pain and symptom control, supportive care topics, and whatever else that might fit into the theme.

*Note: This website is not affiliated with Alberta Health Services (AHS) or CAPhO and the opinions expressed herewithin are that of the author(s).

Pharmacy History

"The earliest known compilation of medicinal substances was ARIANA the Sushruta Samhita, an Indian Ayurvedic treatise attributed to Sushruta in the 6th century BC. However, the earliest text as preserved dates to the 3rd or 4th century AD.Many Sumerian (late 6th millennium BC - early 2nd millennium BC) cuneiform clay tablets record prescriptions for medicine.[3]

Ancient Egyptian pharmacological knowledge was recorded in various papyri such as the Ebers Papyrus of 1550 BC, and the Edwin Smith Papyrus of the 16th century BC.

The earliest known Chinese manual on materia medica is the Shennong Bencao Jing (The Divine Farmer's Herb-Root Classic), dating back to the 1st century AD. It was compiled during the Han dynasty and was attributed to the mythical Shennong. Earlier literature included lists of prescriptions for specific ailments, exemplified by a manuscript "Recipes for 52 Ailments", found in the Mawangdui tomb, sealed in 168 BC. Further details on Chinese pharmacy can be found in the Pharmacy in China article."

Journal of Palliative Medicine - Table of Contents

Traditional Romanian Pharmacy

The Sibiu Pharmacy Museum in Sibiu, Transylvania, Romania, is housed in a 1569 Gothic townhouse where the oldest pharmacy in Romania operated for over 150 years. The pharmacy was known as La Ursul Negru (The Black Bear).

Sir William Osler: "It is much more important to know what sort of a person has a disease than what sort of disease a patient has."

William Osler is regarded as McGill’s most eminent medical graduate and, as Professor of the Institutes of Medicine, the most eminent member of the McGill Medical Faculty. At the time of his death (1919), he was without question the best known and best loved physician in the English-speaking world.